An unusual occurrence of giant primary osteosarcoma of chest wall in adult: case report and review of literature

Osteosarcoma is most frequently occurring bone malignancy which commonly occurs in the ends of the long bone. Usually osteosarcomas do not involve the bones of the chest wall. 22 year old patient presented with swelling in left anterior chest wall gradually enlarging over the period of 1 year accompanied by dull aching pain in the same. On examination there was 30×25 cm large hard irregular swelling which was fixed to chest wall. CECT Thorax was suggestive of 30×25×18 cm sized soft tissue lesion involving 3, 4, 5 rib involvement with sunburst periosteal reaction. Mass is having large extrathoracic with small intrathoracic extensions. Moderate pleural effusion was noted. Core biopsy of mass identified the tumor as osteosarcoma. Primary malignant bone tumors of the chest wall are very rare entity. Of these tumors chondrosarcomas are the most frequent. Chondrosarcoma are chemo-resistant as compared to osteosarcomas. Management of such tumors should follow the same oncological principles of resection with wide margins whenever possible. Neoadjuvant chemotherapy may be given in cases of responsive etiologies like Ewing sarcoma or osteosarcoma. These malignancies generally have poor prognosis.